Provider Demographics
NPI:1740735661
Name:HINES, OLIVIA (LPC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:HINES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:7635 HULL STREET RD
Mailing Address - Street 2:201
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7635 HULL STREET RD
Practice Address - Street 2:201
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6436
Practice Address - Country:US
Practice Address - Phone:804-447-6382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health